A well-executed Norwood 2 transplant produces a continuous, natural-looking hairline where the temple recession was previously visible. Because graft counts are relatively low (800-1,500), the procedure is straightforward for an experienced surgeon and recovery is faster than at higher Norwood stages.
What "Before" Looks Like at Norwood 2
At Norwood 2, the typical pre-surgery presentation includes:
- Bilateral temple recession forming a triangular or angular shape on each side
- The frontal mid-point of the hairline may remain in its original position (classic Norwood 2) or have lifted slightly (Norwood 2A)
- Hair in the receded temple zone is often thinner and shorter than adjacent native hair due to miniaturization
- In good lighting, the contrast between the temple recession and the hairline is the most visible issue
- The crown, mid-scalp, and most of the hairline remain intact
The "before" at Norwood 2 often bothers patients more than it appears to bother others. Because the loss is concentrated in the temples, it changes the perceived shape of the face and hairline but does not affect overall hair coverage significantly.
The Typical Result Timeline
Understanding the result timeline prevents disappointment in the early post-surgery months. The standard progression after a Norwood 2 FUE transplant:
| Week/Month | What Is Happening |
|---|---|
| Week 1-2 | Scabbing at recipient sites, mild swelling (resolves in 5-7 days) |
| Week 2-4 | Shock loss: transplanted hairs shed. This is normal and expected. |
| Month 1-3 | Grafts in resting (telogen) phase. Scalp looks similar to pre-surgery. |
| Month 3-4 | New hair growth begins emerging from transplanted follicles. |
| Month 6 | 40-60% of final result visible. Hair is present but fine and short. |
| Month 9 | 70-80% of final result visible. Hair is thickening and taking on natural color. |
| Month 12-18 | Final result. Full density, natural texture, all grafts that survived have grown in. |
The shock loss phase (weeks 2-4) is the period most patients find distressing. The transplanted hairs shed while the follicle enters a growth cycle. The follicle is intact and healthy; the shedding is the normal response to surgical relocation. Most surgeons warn patients explicitly about this phase before surgery.
What Distinguishes an Excellent Norwood 2 Result
The difference between an excellent result and a disappointing one at Norwood 2 comes down to three factors:
Hairline Design
The frontal hairline design is the most artistically demanding part of a Norwood 2 transplant. An excellent design:
- Sets the hairline at an age-appropriate height, not at the lowest possible position
- Creates a slightly irregular, non-linear hairline edge (natural hairlines are not perfectly straight)
- Matches the temple peaks to the proportions of the patient's face
- Accounts for the patient's likely future hairline if progression continues
- Places single-follicular-unit grafts (1 hair each) at the very edge, with 2- and 3-unit grafts behind them
An artificial-looking result at Norwood 2 is almost always caused by an overly straight or overly low hairline, or by using multi-unit grafts at the hairline edge.
Angle and Direction of Graft Placement
Each graft must be implanted at the correct angle and in the correct direction to match surrounding native hair. Temple hair grows at a sharp angle (almost parallel to the scalp surface) and sweeps forward. Hairline hair grows at approximately 30-40 degrees and sweeps in the natural direction of the patient's hair.
Incorrect angles produce hair that stands away from the scalp or grows against the natural direction. This is visible, especially in wet or slicked-back hair, and is a hallmark of lower-quality outcomes.
Graft Survival Rate
Not every extracted graft survives the transplantation process. Graft survival depends on:
- Time outside the body (the shorter, the better)
- Storage solution used (saline vs. Hypothermosol vs. ATP solution)
- Hydration of grafts during surgery
- Skill of the implantation
- Patient factors (scalp vascularity, smoking status, medications)
A graft survival rate of 90-95% is considered excellent. A rate of 75-80% is acceptable but means a meaningful portion of extracted grafts did not survive. At 1,000 grafts, the difference between 90% and 80% survival is 100 grafts, which translates to a noticeable density difference.
Case Profile 1: 32-Year-Old at Norwood 2
Patient profile: 32 years old, Norwood 2, on finasteride for 2 years with stable hair loss for 18 months. 1,100 grafts FUE, Istanbul.
Before: Bilateral temple recession approximately 1.5 cm deep. Frontal hairline intact but temples clearly receded, creating an M-shape.
Procedure: 600 grafts to the temples (300 per side), 400 grafts to reinforce the frontal hairline edge, 100 grafts to the border zone. Single-unit grafts at the hairline edge, double units behind.
12-month result: Temple peaks restored to a natural position. Hairline appears continuous from front view. Temples still slightly less dense than frontal native hair under bright overhead lighting, but undetectable in normal conditions.
Assessment: Excellent. The age-appropriate design and conservative graft use mean the result will remain natural even if minor progression occurs in the next decade.
Case Profile 2: 26-Year-Old at Norwood 2 (Cautionary Example)
Patient profile: 26 years old, Norwood 2, not on finasteride. Opted for surgery at a high-volume clinic. 1,500 grafts FUE.
Before: Bilateral temple recession, slight hairline lift centrally. Active progression suspected.
Immediate post-surgery result: Very low, dense hairline with restored temples. Aesthetically impressive at 12 months.
At 5 years post-surgery: Patient had progressed to Norwood 3.5. Native hair behind the transplanted hairline thinned significantly, creating an isolated strip of dense frontal hair against a thinning mid-scalp. Second procedure required.
Assessment: Result was good surgically but the timing was wrong. Surgery at 26 without finasteride and without confirmed stability set up a predictable corrective surgery cycle. This case illustrates why stable progression and medication use are prerequisites for most surgeons.
Case Profile 3: 42-Year-Old at Norwood 2
Patient profile: 42 years old, Norwood 2, no significant progression in 10 years. Not on finasteride (stable without it). 900 grafts FUE, UK clinic.
Before: Mild bilateral temple recession that had been static for years. Hairline otherwise intact.
12-month result: Temples restored. Hairline natural and undetectable. Patient age means progression risk is low.
Assessment: Excellent candidate at excellent timing. Older patients with stable Norwood 2 often achieve the most predictable, satisfying outcomes.
How to Evaluate Before-and-After Photos From Clinics
When reviewing clinic photo galleries, apply a structured evaluation:
Lighting consistency: Are the before and after photos taken in comparable lighting? Photos that show the "before" under bright overhead lighting (which exaggerates recession) and the "after" under soft side lighting (which minimizes density) are misleading.
Angle consistency: Before and after should be from identical angles. A slight downward tilt in the "after" photo makes hair look thicker than a straight-on view.
Time since surgery: After photos taken at 6 months are not final results. Look for photos explicitly labeled as 12+ months post-surgery.
Natural hairline characteristics: Does the "after" hairline have slight irregularity at the edge, or is it unnaturally straight and uniform? Natural-looking results have slight irregularity.
Volume of cases shown: A clinic that shows 500 results is more representative than one showing 10 cherry-picked cases.
For more context on what to expect financially, see the Norwood 2 cost breakdown.
Get a free AI hairline assessment at myhairline.ai to measure your current recession depth and track changes over time with consistent, geometry-based measurements.
FAQ
What do Norwood 2 before and after results look like?
A successful Norwood 2 transplant restores the temple recession and refines the frontal hairline with natural-looking single-unit grafts. The before shows triangular temple recession; the after shows a continuous hairline with matched density. Full results take 12-18 months to appear.
How long before you see results after a Norwood 2 transplant?
The timeline is: grafts shed in weeks 2-4 (shock loss), new growth begins at 3-4 months, 70-80% of the result is visible by 9 months, and the final result is reached at 12-18 months. Patience is essential as early months do not reflect the final outcome.
What makes a Norwood 2 transplant result look natural?
Natural results depend on three things: correct hairline design (age-appropriate position, irregular frontal edge), precise angle and direction of single-unit grafts at the hairline, and appropriate density (35-45 units/cm2). Overly dense, symmetrically perfect hairlines often look artificial.